POS1225 PATIENT GLOBAL ASSESSMENT AND INFLAMMATORY MARKERS IN PATIENTS WITH IDIOPATHIC INFLAMMATORY MYOPATHIES – A LONGITUDINAL STUDY FROM THE MYONET COHORT
Authors: K. Lodin, F. Espinosa-Ortega, M. Dastmalchi, H. Alexanderson, J. Vencovský, H. Andersson, H. Chinoy, J. B. Lilleker, N. Steen Krogh, R. P. New, S. Katsuyuki Shinjo, B. Maurer, Z. Griger, Y. Tavor, A. Ceribelli, D. Gomez, M. Vázquez-Del Mercado Espinosa, D. Leonard, A. Erler, I. E. Lundberg
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Idiopathic inflammatory myopathies (IIM) constitute a heterogeneous group of diseases with systemic inflammation. Inflammation has previously been associated with poor subjective health appraisal in both acute and chronic inflammatory diseases [1-5]. <h3>Objectives</h3> To explore if the patient-reported outcome measure "patient global assessment" (PGA) is associated with markers of inflammation over time and if associations could be explained by functional measures in patients with IIM. <h3>Methods</h3> PGA and inflammatory markers longitudinally collected over 5 years were retrieved for 1333 patients with IIM from the international MyoNet registry. Associations between PGA, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and creatine kinase (CK) were analyzed with mixed effect regression analyses. Mediation analysis was used to test if the associations between PGA and inflammatory markers could be explained by disease-associated symptoms and signs. <h3>Results</h3> PGA improved and inflammatory markers decreased during the first year of observation. High levels of ESR and CRP were associated with worse PGA in both men (ESR:<i>b</i>=0.21, 95%CI 0.10-0.32, p&lt;0.001, CRP:<i>b</i>=0.16, 95%CI 0.04-0.29, p=0.012) and women (ESR:<i>b</i>=0.34, 95%CI 0.25-0.42, p&lt;0.001, CRP:<i>b</i>=0.26, 95%CI 0.14-0.37, p&lt;0.001) across time points, and CK was associated with PGA in women (<i>b</i>=0.70, 95%CI 0.48-0.93 p&lt;0.001) but not in men (<i>b</i>=0.07, 95%CI -0.54-0.68, p=0.831). In men, the association between elevated inflammatory markers and poorer PGA was explained by disability and extra-muscular disease activity whereas in women this association could not be explained by any of the included functional measures. With a few exceptions, the association between reduced inflammatory markers and improved PGA during the first year of observation was partially mediated by improvements in all functional measures. <h3>Conclusion</h3> Higher levels of systemic inflammation were associated with poorer PGA in patients with IIM. In addition to known benefits of lowered inflammation, these findings emphasize the need to reduce systemic inflammation to improve subjective health. <h3>References</h3> [1]Kananen L, Enroth L, Raitanen J, Jylhävä J, Bürkle A, Moreno-Villanueva M, et al. Self-rated health in individuals with and without disease is associated with multiple biomarkers representing multiple biological domains. Scientific Reports. 2021;11(1):6139. [2]Lodin K, Lekander M, Syk J, Alving K, Petrovic P, Andreasson A. Longitudinal co-variations between inflammatory cytokines, lung function and patient reported outcomes in patients with asthma. PloS one. 2017;12(9):e0185019. [3]Warnoff C, Lekander M, Hemmingsson T, Sorjonen K, Melin B, Andreasson A. Is poor self-rated health associated with low-grade inflammation in 43,110 late adolescent men of the general population? A cross-sectional study. BMJ open. 2016;6(4):e009440. [4]Tanno K, Ohsawa M, Onoda T, Itai K, Sakata K, Tanaka F, et al. Poor self-rated health is significantly associated with elevated C-reactive protein levels in women, but not in men, in the Japanese general population. J Psychosom Res. 2012;73(3):225-31. [5]Lekander M, Elofsson S, Neve IM, Hansson LO, Unden AL. Self-rated health is related to levels of circulating cytokines. Psychosom Med. 2004;66(4):559-63. <h3> Acknowledgements</h3> On behalf of all MyoNet contributor.s. <h3>Disclosure of Interests</h3> Karin Lodin: None declared, Fabricio Espinosa-Ortega: None declared, Maryam Dastmalchi: None declared, Helene Alexanderson: None declared, Jiří Vencovský: None declared, Helena Andersson: None declared, Hector Chinoy: None declared, James B. Lilleker: None declared, Niels Steen Krogh: None declared, Robert Paul New: None declared, Samuel Katsuyuki Shinjo: None declared, Britta Maurer: None declared, Zoltán Griger: None declared, Yonit Tavor: None declared, Angela Ceribelli: None declared, Diana Gomez: None declared, Mónica Vázquez-Del Mercado Espinosa: None declared, Dag Leonard: None declared, Anne Erler: None declared, Ingrid E. Lundberg Grant/research support from: I.E.L. has received consulting fees from Corbus Pharmaceuticals, Inc and research grants from Astra Zeneca and has been serving on the advisory board for Corbus Pharmaceutical, EMD Serono. Research &amp; Development Institute, Argenx, Octapharma, Kezaar, Orphazyme, Pfizer and Janssen and has stock shares in Roche and Novartis.